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BACKGROUND Shigellosis, an acute diarrheal disease, is the third most common bacterial infection in the United States. Shigellosis most commonly affects children under the age of 5; however, clusters and outbreaks of shigellosis have been reported among gay, bisexual, and other men who have sex with men (MSM). Evidence suggests that knowledge of shigellosis among MSM is low, indicating health promotion outreach is needed for this population. METHODS To inform the development of shigellosis-related health communication materials and strategies, six focus groups were conducted in 2017, in Atlanta, Georgia among 24 self-identified gay and bisexual men. Participants were asked about their preferences and recommendations for health communication materials. RESULTS Participants indicated they would prefer a range of physical and virtual materials placed in diverse locations where the community would see them. Respondents recommended health messages be simple, quick to read, and concise and have limited word counts. Participants also advised the use of diverse images that were inclusive of couples of varying sexual orientations to reduce stigma. Participants advocated for the use of humor and provocative images to increase user engagement. CONCLUSIONS The results emphasize the potential benefits of conducting formative research when designing health communication materials. Incorporating messaging preferences of MSM in the development of shigellosis-related health communication materials could enhance their relevance for the target population, while also avoiding unintended consequences associated with stigmatizing MSM.

No doubts that shigellosis severity directly depends on the spread of the gut specific lesion. There are some data published on the basis of autopsy records and pointing to shigella caused lesion spreading both to colon and ileum in adult cases especially in those older than 60 y.o. or with any immunosuppressive premorbid background. Obviously, the gut mucosa condition determines the local resistance potential and moreover it's shown that in shigellosis cases, the histologic pattern of gut mucosa depends on quantity and quality of neutrophils, extremely important to control the intensity of agent invasion. Viral infections with concomitant neutropenia are commonly considered as immune suppressive conditions. As to Herpes virus infection, it's well known as the large mucosa lesion disease that can subsequently lead to aggravation of any forthcoming acute bacterial infection. The paper suggests the description of shigellosis case confirmed with the use of PCR test (PCR kit Amplisens All-bacto-screen-FL Lab, Interlabservice) and developed by young woman with unfavorable premorbid condition. The disease course turned to be severe and complicated by the peritonitis development. The aggravating factors in the proposed case were likely such immune modulating concurrent conditions as Herpes virus infection and pregnancy. The clinical example demonstrates that young people can develop severe complicated shigellosis course given burdened premorbid background availability.

Background: Shigellosis is an infectious intestinal disease common in rural communities. In developing countries, shigellosis is caused predominantly by Shigella flexneri and has been determined as a major cause of morbidity and mortality. Objective: The study investigates the anti-biofilm, anti-microbial, and anti-shigellosis activity of a designed formulation. Materials and methods: The potential of the formulation against S. flexneri (MTCC 1457) was investigated using a well-diffusion assay. Further, the effect of the designed formulation on bacterial growth and biofilm formation was analyzed by the spectrophotometry method. Anti-quorum sensing activity was analyzed using Chromobacterium violaceum CV026, a bacterial strain. Finally, the cytotoxicity of the formulation was examined by using cell line and brine shrimp lethality assay. Results: The MIC value of the aqueous extract of the formulation was 2.4 mg ml−1 and an inhibitory zone of 23 mm was observed. On the other side, the formulation significantly inhibited the bacterial growth, biofilm formation (23.78%), violacein inhibition (27.68%) at 0.6 mg ml−1 concentration (did not significantly affect the growth curves) and was found non-toxic in cell assay and brine shrimp lethality assay. Conclusion: According to the result obtained, the designed formulation was found effective and non-toxic, so it can be used to treat shigellosis and Shigella-related infections.

The ways of improving of diet management in children with Shigellosis infected with H. pylori were determined. The study involved 29 children with H. pylori infection aged from 1 to 10, who were hospitalized in the Regional Children’s Infectious Diseases Hospital (Kharkiv) and had a diagnosis of Shigellosis sonnei of moderate severity. The children were divided into two groups depending on the feeding mode. The first group was represented by 13 children, who were undergone standard treatment. The second group included 16 children who had two days prolonged gradual increase in the volume of food at each feeding, and decreased number of feedings per day. Children of the second group received aluminum phosphate from the first day and after discharge they were advised to keep on the regime of feeding «more frequently, but in small portions». A longer duration of the symptoms of bowel dysfunction and vomiting, pain in periumbilical area, bloating, changes in fecal examination in the form of the presence of undigested food in children of the first group were revealed. Patients of the second group regained their weight in much shorter period. Rational diet therapy makes it possible to prevent recrudescence of shi­gellosis in children at early stages of recovery. Studies have shown that early detection of H. pylori infection in children with shigellosis as well as timely correction of feeding have a positive effect on recovery of functional activity of digestive processes, faster normalization of clinical and laboratory parameters of patients, contribute to regression of clinical symptoms of the underlying disease.

Worldwide, foodborne illness is a significant public health issue in both developed and developing countries. Salmonellosis, campylobacteriosis and shigellosis are common foodborne gastrointestinal illnesses caused by the bacteria Salmonella spp., Campylobacter spp. and Shigella spp. respectively. These zoonotic diseases are frequently linked to eggs and poultry products. The aim of this study was to investigate the presence of these pathogens in Australian backyard poultry flocks and to determine risk factors for these pathogens. Poultry faeces samples were collected from 82 backyards and screened for Salmonella spp., Campylobacter spp. and Shigella spp. using qPCR. A questionnaire was administered to the backyard poultry owners to assess their knowledge regarding management of poultry and eggs and to identify potential risk factors that may contribute to the presence of zoonotic pathogens in the flocks. One composite faecal sample was collected from each backyard (82 samples). Composite sampling here means taking one or more grab samples from a backyard to make up approximately 10 grams. Four per cent of samples, that is 4% backyards tested, were positive for Salmonella spp., 10% were positive for Campylobacter spp. and none were positive for Shigella spp. A higher infection rate was seen in multi-aged flocks (24%) compared with the single-aged flocks (3%). The survey found that many participants were engaging in risky food safety behaviours with 46% of participants responding that they washed their eggs with running water or still water instead of wiping the dirt off with a damp cloth to clean the eggs and 19% stored their eggs at room temperature. This study demonstrated that backyard poultry may pose a potential risk for salmonellosis and campylobacteriosis. Additionally, Australian public health and food safety regulations should be modified and effectively implemented to address the risks associated with backyard poultry husbandry.

This cross-sectional, institutional-based study aimed to determine the prevalence of shigellosis and associated risk factors among Babcock University students in Ogun State, Nigeria. One hundred and twenty (120) undergraduate students, 80 females and 40 males, were asked to provide stool specimen in a sterile leak-proof single-use universal bottle with a screw-capped lid. Standard microbiological techniques were used to analyse the stool samples. A questionnaire was designed to collect demographic and clinical information from participants. The data obtained were statistically analysed using the SPSS Statistics software (version 18.0). The study showed that there was no occurrence of shigellosis among the study participants (0%), but other enteric pathogens infection were present in all participants (100%). The three most common mono-infections found among the study participants included Staphylococcus aureus (40%), followed by Escherichia coli (16.7%), and Salmonella typhi and Bacillus spp. (3.3%, each). While the most common prevalence of dual-infections included Staphylococcus aureus and Escherichia coli (33.3%), followed by Staphylococcus aureus and Salmonella typhi (3.3%). The proportion of participants who were asymptomatic (66.7%) was significantly higher than the symptomatic ones (33.3%). Identified risk factors of non-Shigella enteric infection included consumption of beef, vegetables, fruits, poultry/poultry products, as well as street foods, poor hand hygiene before eating, anal cleaning, and poor hand hygiene after toileting. Although shigellosis did not exist among undergraduate students of Babcock University, this study highlighted the existence of other enteric infections among the study participants. Therefore, the necessary preventive measures should be ensured and sustained.

Background: Mortality due to enteric infections is projected to increase because of global warming; however, the different temperature sensitivities of major enteric pathogens have not yet been considered in projections on a global scale. We aimed to project global temperature-attributable enteric infection mortality under various future scenarios of sociodemographic development and climate change. Methods: In this modelling study, we generated global projections in two stages. First, we forecasted baseline mortality from ten enteropathogens (non-typhoidal salmonella, Shigella, Campylobacter, cholera, enteropathogenic Escherichia coli, enterotoxigenic E coli, typhoid, rotavirus, norovirus, and Cryptosporidium) under several future sociodemographic development and health investment scenarios (ie, pessimistic, intermediate, and optimistic). We then estimated the mortality change from baseline attributable to global warming using the product of projected annual temperature anomalies and pathogen-specific temperature sensitivities. Findings: We estimated that in the period 2080–95, the global mean number of temperature-attributable deaths due to enteric infections could be as low as 6599 (95% empirical CI 5441–7757) under the optimistic sociodemographic development and climate change scenario, or as high as 83 888 (67 760–100 015) under the pessimistic scenario. Most of the projected temperature-attributable deaths were from shigellosis, cryptosporidiosis, and typhoid fever in sub-Saharan Africa and South Asia. Considerable reductions in the number of attributable deaths were from viral infections, such as rotaviral and noroviral enteritis, which resulted in net reductions in attributable enteric infection mortality under optimistic scenarios for Latin America and the Caribbean and East Asia and the Pacific. Interpretation: Temperature-attributable mortality could increase under warmer climate and unfavourable sociodemographic conditions. Mitigation policies for limiting global warming and sociodemographic development policies for low-income and middle-income countries might help reduce mortality from enteric infections in the future. Funding: Japan Society for the Promotion of Science, Japan Science and Technology Agency, and Spanish Ministry of Economy, Industry, and Competitiveness., The Lancet Planetary Health, 5(7), pp. e436-e445; 2021

Background The natural hosts of Shigella are typically humans and other primates, but it has been shown that the host range of Shigella has expanded to many animals. Although Shigella is becoming a major threat to animals, there is limited information on the genetic background of local strains. The purpose of this study was to assess the presence of virulence factors and the molecular characteristics of S. flexneri isolated from calves with diarrhea. Results Fifty-four S. flexneri isolates from Gansun, Shanxi, Qinghai, Xinjiang and Tibet obtained during 2014 to 2016 possessed four typical biochemical characteristics of Shigella. The prevalences of ipaH, virA, ipaBCD, ial, sen, set1A, set1B and stx were 100 %, 100 %, 77.78 %, 79.63 %, 48.15 %, 48.15 and 0 %, respectively. Multilocus variable number tandem repeat analysis (MLVA) based on 8 variable number of tandem repeat (VNTR) loci discriminated the isolates into 39 different MLVA types (MTs), pulsed field gel electrophoresis (PFGE) based on NotI digestion divided the 54 isolates into 31 PFGE types (PTs), and multilocus sequence typing (MLST) based on 15 housekeeping genes differentiated the isolates into 7 MLST sequence types (STs). Conclusions The findings from this study enrich our knowledge of the molecular characteristics of S. flexneri collected from calves with diarrhea, which will be important for addressing clinical and epidemiological issues regarding shigellosis.

Shigellosis, a diarrheal disorder caused by an entero-invasive bacterium Shigella, is a major concern among children often leading to mortality. As most of these strains have developed universal antibiotic resistance, the development of a vaccine is crucial in combating the infection. The O-specific polysaccharide (O-PSs) from S. flexneri type 2a is considered to be the major disease-causing antigen in shigellosis. Therefore, the O-PSs conjugated with carrier proteins, can serve as a potential high molecular weight vaccine candidate. Accordingly, in the present study, O-PS extracted from S. flexneri 2a is conjugated with Cross-Reactive Material (CRM197), a non-toxic mutant of diphtheria toxin. We derivatized CRM197 and O-PS separately with adipic acid dihydrazide (ADH) and reacted with their counterparts to probe the conjugation efficacy. Among the two strategies, the CRM197-ADH treated with O-PS has yielded a stable glycoconjugate of 311 kDa. The conjugation efficiency has been probed by estimating the free protein, free O-PS and O-PS:CRM197 ratio using slot-blot, size exclusion and high-performance anion exchange chromatography techniques. The conjugate exhibited enhanced shelf-life of three months. The cytotoxicity studies with Vero/MRC-5 cells have confirmed the non-toxicity of the conjugate, which makes the glycoconjugate a potential vaccine candidate for shigellosis.

Both Campylobacter- and Shigella-induced invasive enteritis are common in under-5 Bangladeshi children. Our study aimed to determine the factors associated with Campylobacter and Shigella enteritis among under-5 children, the post-infection worsening growth, and the household cost of invasive enteritis. Data of children having Shigella (591/803) and Campylobacter (246/1148) isolated from the fecal specimen in Bangladesh were extracted from the Global Enteric Multicenter Study (GEMS) for the period December 2007 to March 2011. In multiple logistic regression analysis, fever was observed more frequently among shigellosis cases [adjusted OR 2.21; (95% CI 1.58, 3.09)]. Breastfeeding [aOR 0.55; (95% CI 0.37, 0.81)] was found to be protective against Shigella. The generalized estimating equations multivariable model identified a negative association between Shigella and weight-for-height z score [aOR − 0.11; (95% CI − 0.21, − 0.001)]; a positive association between symptomatic Campylobacter and weight-for-age z score [aOR 0.22; (95% CI 0.06, 0.37)] and weight-for-height z score [aOR 0.22; (95% CI 0.08, 0.37)]. Total costs incurred by households were more in shigellosis children than Campylobacter-induced enteritis ($4.27 vs. $3.49). Households with low-level maternal education tended to incur less cost in case of their shigellosis children. Our findings underscore the need for preventive strategies targeting Shigella infection, which could potentially reduce the disease burden, associated household costs, and child growth faltering.

This study was designed to investigate the prevalence and associated risk factors of Shigella flexneri isolated from drinking water and retail raw food samples in Peshawar, Pakistan. A total of 1,020 different samples were collected from various areas of Peshawar between January 2016 and May 2017, followed by identification of S. flexneri through biochemical, serological, and 16S rRNA gene sequencing. Potential risk factors associated with the development and spreading of S. flexneri infection were also investigated. Overall, 45 (4.41%) samples were positive for Shigella species. Among these samples, the predominant species was S. flexneri (n = 44) followed by S. boydii (n = 1). Interestingly, S. sonnei and S. dysenteriae isolates were not found in any sample. The isolation rate of S. flexneri in drinking water samples, market raw milk, and fruits/vegetables from Peshawar were 6.47%, 3.5%, and 2.9%, respectively. The phylogenetic reconstruction showed genetic diversity among three clades, as clades I and II have isolates of S. flexneri that were circulating within the drinking water, milk, fruits/vegetables, while clade III isolates were recovered from milk samples. Most of S. flexneri were detected in June to September. Potential risk factors of S. flexneri were water sources contaminated by toilet wastes (p = 0.04), surface water drainage (p = 0.0002), hospital wastes (p = 0.01), unhygienic handling (p < 0.05), and transportation of raw food (p = 0.04). In conclusion, S. flexneri isolates of closely related lineage originating from non-clinical samples might be associated with an increased human risk to shigellosis in Pakistan, as significant numbers of S. flexneri were observed in the drinking water and retail raw food samples. PRACTICAL APPLICATION: This study demonstrated the presence of S. flexneri in drinking water and retail raw food samples which seem to possess a serious threat to public health. Potential sources of food and water contamination should properly be monitored by public health authorities to reduce cases of shigellosis.

Foodborne diseases are considered a relevant issue in health around the world due to their incidence, mortality and negative effects on the economic and productive sector. Fish is considered a food of high nutritional quality, being of global production, distribution and commercialization mainly for human consumption. Among the fish worldwide obtained from capture fisheries and mainly aquaculture for human consumption is Tilapia, due to the adaptability of this fish under cultivation conditions in addition to the fact that its meat is of quality and accessible economic value. Fish due to its composition, is highly susceptible to deterioration and contamination by different hazards throughout the food chain, putting the safety of products and public health at risk. Shigellosis is among the diseases that may be contracted from the consumption of food contaminated by bacteria of the genus Shigella spp.; food contamination is mainly related to inadequate or non-hygienic conditions and practices in the production, processing and handling of food. Therefore, the purpose of this review is to provide a general perspective of foodborne diseases, especially shigellosis, causal agents, conditioning factors, related foods such as fish, as well as control and preventive actions in order to protect the food safety and public health. Key words: Food pathogens, food safety, food microbiology, enterobacteria, fisheries, aquaculture.

Dried crayfish is a rich source of protein and an important crustacean consumed all over the world.To determine the occurrence of Salmonella and Shigella in dried crayfish and crayfish sellers practices which may predispose the food item to microbial contamination, dried crayfish were sampled from 100 stalls in Samaru (n=20), Sabo (n=30) and Central market (n=50) markets of Kaduna state. Dried crayfish samples were each homogenized, analyzed for total coliform plate count, then pre-enriched and enriched in peptone water and Rappaport-Vassiliadis broth respectively, which was further cultured on Salmonella Shigella Agar (SSA). Non-lactose fermenting colonies were subjected to biochemical and Sugar tests. The overall mean coliform count was 14.95log10cfu/100ml. Salmonella and Shigella species were isolated from 12 (35.3%) and 5 (14.3%) samples respectively. Locational distribution of dried crayfish showed, Sabon gari (13.3%) and Central market Kaduna (6%) having the highest occurrence of Salmonella and Shigella suspect species respectively. Questionnaire survey administered to 100 of the crayfish sellers revealed that most of them 71 (74%) eat uncooked dried crayfish, 39% (44/100) of them use their bare hands unwashed while packaging the crayfish at point of sale. The presence of Salmonella and Shigella in crayfish from these locations is of public health significance. Therefore, public enlightenment on hygiene, sanitation and proper storage and packaging of crayfish to prevent foodborne disease outbreak such as Salmonellosis and Shigellosis in Nigeria is highly advocated. Key words: Crayfish, Salmonella, Shigella, food contamination and hygiene

Background and aim: Shigella is one of the leading causes of acute diarrhea in children worldwide. Antibiotic resistance in this bacterium has increased due to the indiscriminate use of common antibiotics. Therefore, the aim of this study was to investigate the prevalence and pattern of antibiotic resistance in Shigella species isolated from children with acute diarrhea in Tabriz hospitals. Materials and methods: In this descriptive cross-sectional study, 321 samples suspected of Shigella were collected from children's diarrhea stool samples and identified using standard microbiological and biochemical tests. Antibiotic resistance was also determined using disk diffusion by the Kirby-Bauer method. Results: A total of 84 samples were positive for Shigella. Among them, S. flexneri species with 83.3% had the highest frequency and S. boydii with 13.1%, S. sonnei with 2.4% and S. dysanteriae with 1.2% had the lowest frequency. The highest resistance was related to the antibiotics cotrimoxazole (92.85%), tetracycline and ampicillin (67.86%) and the lowest resistance was related to imipenem antibiotics (2.38%) and ceftizoxime (9.52%). Conclusion: The present study showed that Shigella flexneri is the predominant species isolated from children with Shigellosis in hospitals in Tabriz city. Our results also indicate an increase in resistance to common antibiotics. Therefore, it is recommended that antimicrobial susceptibility testing be performed in the study area prior to antibiotic administration.

Enteric infection with Shigella spp. can lead to symptoms ranging from acute watery diarrhea to sudden, severe dysentery. Approximately 212 000 diarrheal deaths annually are attributed to Shigella with a disproportionate impact in low-resource countries. The impact in under-resourced countries was illustrated by a reanalysis of the Global Enteric Multicenter Study which found that Shigella was the leading pathogen associated with moderate-to severe diarrhea in children under 5 years old. While recent studies have highlighted the burden of the disease, there has been a concurrent reduction in therapeutic options for the treatment of shigellosis as drug resistant strains increase in prevalence. In addition, increasing reports of drug resistant shigellosis cases in the men who have sex with men community confirm that the impact is not limited to low-resource countries. Despite the urgent need for new treatments, a target product profile (TPP) has not been established, and there is no clear development path for antibacterial treatments. To address this troubling concern, this manuscript describes a TPP for antishigellosis small molecule therapeutics and a development path that integrates currently available preclinical and clinical models of Shigella infection.

Introduction: In the Karachay-Cherkess Republic (KCR), dysentery and salmonellosis rank high in the etiological structure of intestinal infections and arose interest in studying the incidence of shigellosis in the republic. Our objective was to analyze the incidence of bacillary dysentery, to study Shigella landscape in the territory of the KCR in 2005–2019, and to compare the findings with similar variables in other regions of the Russian Federation. Materials and methods: We analyzed data of the Center for Hygiene and Epidemiology in the Karachay-Cherkess Republic on the incidence of shigellosis and Shigella isolates obtained from human stool samples in the KCR in 2005–2019 and compared them with available results of similar studies conducted in other parts of the country. Results: When analyzing the curves of the incidence of dysentery in the KCR and the Russian Federation, we found that they were asynchronous. In the KCR, the curve rose twice (in 2005–2006 and 2011–2014), while in the Russian Federation, the incidence rates demonstrated a gradual decrease. Over the whole observation period, only in 2018–2019 the incidence of shigellosis in Karachay-Cherkessia was 1.3–1.8 times lower than in the country as a whole. We also established that, in contrast to the Russian Federation, Shigella sonnei represented by the biochemical variant IIg prevailed in the structure of shigellosis in the republic. The analysis of the relationship between the number of detected samples of dairy products of poor microbial quality and the incidence rate of Sonne dysentery showed that those two variables did not always correlate. Molecular genotyping of Shigella sonnei strains by pulsed-field gel electrophoresis (PFGE) allowed us to assume the imported nature of the pathogen. The import could have occurred during the Hajj to Mecca and Medina of KCR residents in 2012. Conclusion: Shigella sonnei strains differing in the presence of tetracycline and chloramphenicol (levomycetin) resistance determinants are circulating in Karachay-Cherkessia. No bacteria resistant to ciprofloxacin were isolated in the republic in 2005–2019.

The aim of this work is to study the etiological and epidemiological features of infectious hemocolites (IG) in hospitalized children of different ages.Materials and methods of research. An analysis of the results of a survey of 3103 children admitted to hospital treatment for acute intestinal infections (AII) from January to December 2018, among which patients with IG were identified. The etiology of the disease was determined based on the results of the bacteriological method, PCR studies of faeces with Amplicens ® OKI screen-FL reagents, serological and immunological methods. Microscopic examination of faeces was performed to identify protozoa. Patients were divided into age groups: infant (n=78; 30%); early (n=74; 28,5%); preschool (n=63; 24,2%), school (n=45; 17,3%).Results. The incidence of IG in hospitalized children with AII was 8,4%. Bacterial pathogens of IG were detected in 66,5% of children, IG of unspecified etiology was diagnosed in 24,2%. Viral and bacterial infections were rarely detected (9,2%). Among intestinal viruses, rotavirus (37,5%), norovirus (29,2%) and enterovirus (20,8%) were more frequently detected in hemocolitis of combined viral and bacterial etiology. In the IG age structure, infants (30%), young children (28,5%) and pre-school children (24,2%) made up the majority. The maximum number of IG patients was detected in the summer (10,9% of all cases of AII). Salmonellosis was more often detected in autumn (31,6%), campylobacteriosis – in summer (17.9%) and autumn (24,1%), escherichiosis and shigellosis – in summer (11,5% and 6,4%, respectively). The maximum detection of IG in infants was observed in June (14,1%) and October (12,8%), in young children – in July (17,6%), in preschoolers – in June (12,7%) and November (15,9%), in schoolchildren in May (13,3% of cases) and in October (15,6%).Conclusion. The incidence of infectious hemocolites in hospitalized children with acute intestinal infections was 8,4%. The bacterial etiology of the disease was detected in 66,5% of children. The age structure of the IG was dominated by children of infant, early and preschool age. The maximum detection of patients with IG was observed in the summer.

Problem statement From 1999 to 2013 in the Democratic RC, monitoring of bacillary dysentery in bloody diarrhea revealed an average rate of attack in 620 out of 100,000 inhabitants. Within the study period, biological confirmation was available in less than 1% of cases. A dozen dysentery outbreaks were confirmed in laboratories as shigellosis. In this study, our objective is to improve dysentery surveillance. Methods A descriptive method based on epidemiological and biological data was applied, and a literature review was included. Results According to historical research, the first dysentery epidemics occurred in the Mayombe Region in the early 1920s. Spatial dynamics show that the eastern part of the country experienced the highest number of attacks. Time series of bloody diarrhea in the country have revealed a decrease since 2005. No seasonality was found. Conclusion Shigellosis outbreaks have become rare and of low magnitude. Our results suggest a need for further exploration of the causes and determinants of high incidences of bloody diarrhea. Present-day diminution of shigellosis outbreaks calls for research into explanatory factors.

Multidrug resistant Shigella is one of the leading causes of mortality in children and infants. Availability of vaccine could prevent the Shigella infection and reduce the mortality. Conventional approaches of vaccine development against shigellosis have not resulted in desirable vaccine. As shigellosis may be caused by multiple strains and serotypes, there is a need to develop a multivalent vaccine, capable of providing protection against multiple Shigella strains. To develop broad spectrum vaccine, we had previously derived a pool of conserved epitopes against Shigella by using multiple immunoinformatic tools. In this study, the identified conserved epitopes derived from the Outer Membrane Proteins A and C of Shigella were chemically synthesized, and the EpiMix made up of 5 epitopes coupled to a carrier protein, ovalbumin was developed and validated for its immunogenicity. The intramuscular immunization with EpiMix in Balb/c mice led to increase in EpiMix specific serum IgG, and significant increase in fecal IgA as well as in IL-4, IL-2and IFN-γ levels. Further, the EpiMix immunized mice showed protection when challenged against S. flexneri ATCC 12022 using the intraperitoneal route. Moreover, the analysis of cytokine profile and IFN-γ/IL4 ratio in post Shigella challenge immunized mice suggested the high levels of IFN-γ levels and possible dominance of Th1 response, playing pivotal role in the elimination of Shigella. Collectively, the results demonstrate the immunogenic potential and protective efficacy of the EpiMix in the murine shigellosis model. However, the detailed study and further optimisation of epitopes would substantiate the prospective use of EpiMix as a prophylactic candidate for vaccination.

Campylobacteriosis is a disease of worldwide importance, but aspects of its transmission dynamics, particularly risk factors, are still poorly understood. We used data from a matched case-control study of 4,269 men who have sex with men (MSM) and 26,215 controls, combined with national surveillance data on Campylobacter spp., Salmonella spp., and Shigella spp., to calculate matched odds ratios (mORs) for infection among MSM and controls. MSM had higher odds of Campylobacter (mOR 14, 95% CI 10-21) and Shigella (mOR 74, 95% CI 27-203) infections, but not Salmonella (mOR 0.2, 95% CI 0-13), and were less likely than controls to have acquired Campylobacter infection abroad (χ2 = 21; p

Shigella sonnei (S. sonnei) is sometimes sexually transmitted. Men, who have sex with men (MSM), may have sexual behaviours different from heterosexual population, and thus may be at risk for S. sonnei infection. We describe three cases of multidrug-resistant S. sonnei in MSM (one HIV-infected patient and two patients receiving pre-exposure prophylaxis against HIV). S. sonnei was isolated from stool specimens and all patients were successfully treated with parenteral third-generation cephalosporins following laboratory confirmation that the isolates were resistant to azithromycin. Two men (patients 2 and 3) were linked epidemiologically. These cases highlight the emergence of this pathogen and its association with some sexual behaviours among MSM in Franche-Comté, France.

GMMA are exosomes released from engineered Gram-negative bacteria resembling the composition of outer membranes. We applied the GMMA technology for the development of an O-Antigen (OAg) based vaccine against Shigella sonnei, the most epidemiologically relevant cause of shigellosis. S. sonnei OAg has been identified as a key antigen for protective immunity, and GMMA are able to induce anti-OAg-specific IgG response in animal models and healthy adults. The contribution of protein-specific antibodies induced upon vaccination with GMMA has never been fully elucidated. Anti-protein antibodies are induced in mice upon immunization with either OAg-negative and OAg-positive GMMA. Here we demonstrated that OAg chains shield the bacteria from anti-protein antibody binding and therefore anti-OAg antibodies were the main drivers of bactericidal activity against OAg-positive bacteria. Interestingly, antibodies that are not targeting the OAg are functional against OAg-negative bacteria. The immunodominant protein antigens were identified by proteomic analysis. Our study confirms a critical role of the OAg on the immune response induced by S. sonnei GMMA. However, little is known about OAg length and density regulation during infection and, therefore, protein exposure. Hence, the presence of protein antigens on S. sonnei GMMA represents an added value for GMMA vaccines compared to other OAg-based formulations.

Shigellosis is a significant type of diarrhea that causes 160,000 deaths annually in a global scale. The mortality occurs mainly in children less than 5 years of age. No licensed vaccine is available, and conventional efforts for developing an effective and safe vaccine against shigellosis have not been succeeded yet. The reverse vaccinology is a novel promising method that screens genome or proteome of an organism for finding new vaccine candidates. In this study, through reverse vaccinology approach, new vaccine candidates against Shigella flexneri were identified and experimentally evaluated. Proteomes of S. flexneri were obtained from UniProt, and then outer membrane and extracellular proteins were predicted and selected for the evaluation of transmembrane domains, protein conservation, host homology, antigenicity, and solubility. From 103 proteins, 7 high-scored proteins were introduced as novel vaccine candidates, and after B- and T-cell epitope prediction, the best protein was selected for experimental studies. Recombinant protein was expressed, purified, and injected to BALB/c mice. The adhesion inhibitory effect of sera was also studied. The immunized mice demonstrated full protection against the lethal dose challenge. The sera remarkably inhibited S. flexneri adhesion to Caco-2 epithelial cells. The results indicate that identified antigen can serve for vaccine development against shigellosis and support reverse vaccinology for discovering novel effective antigens. Key points • Seven Shigella new antigens were identified by reverse vaccinology (RV) approach. • The best antigen experimented demonstrated full protection against lethal dose. • In vivo results verified RV analyses and suggest FimG as a new potent vaccine candidate. Supplementary Information The online version contains supplementary material available at 10.1007/s00253-020-11054-4.

Availability of clean, safe drinking water is one of the primary needs of human beings. The present study focused on the quality of drinking water in Alappuzha district, in the state of Kerala, India. The harmful concentrations of water-soluble chemicals in drinking water can adversely affect human health. This investigation probed the influence of toxic chemical pollutants on human health. Although concentrations of chemical parameters in the water samples were found to be within the permissible limits, cases of humans infected by waterborne disease such as Leptospirosis, Hepatitis A, and Hepatitis E, Cholera, Shigellosis, and Amoebic meningoencephalitis were reported in the district, in the year 2016. This suggests that microorganisms play a vital role in contaminating water and spreading disease. As many of these diseases are lethal, expedient remedial measures must be undertaken to alleviate their incidence and severity.

Conventional disease surveillance for shigellosis in developing country settings relies on serotyping and low-resolution molecular typing, which fails to contextualise the evolutionary history of the genus. Here, we interrogated a collection of 1,804 Shigella whole genome sequences from organisms isolated in four continental Southeast Asian countries (Thailand, Vietnam, Laos, and Cambodia) over three decades to characterise the evolution of both S. flexneri and S. sonnei. We show that S. sonnei and each major S. flexneri serotype are comprised of genetically diverse populations, the majority of which were likely introduced into Southeast Asia in the 1970s–1990s. Intranational and regional dissemination allowed widespread propagation of both species across the region. Our data indicate that the epidemiology of S. sonnei and the major S. flexneri serotypes were characterised by frequent clonal replacement events, coinciding with changing susceptibility patterns against contemporaneous antimicrobials. We conclude that adaptation to antimicrobial pressure was pivotal to the recent evolutionary trajectory of Shigella in Southeast Asia., Hao Chung The et al. analyze 1,804 Shigella genome sequences from organisms isolated in four Southeast Asian countries over three decades to study the evolution of both S. flexneri and S. sonnei. This study suggests that adaptation to antimicrobial pressure may have played a pivotal role in the recent evolutionary trajectory of Shigella in Southeast Asia.

In recent years, our group isolated the Escherichia albertii strain DM104 and characterized it as a vaccine strain against Shigella dysenteriae type 4 in the guinea pig eye model. Protective efficacy of different routes of immunization such as intranasal, oral, and intrarectal routes were also determined and compared by challenging immunized guinea pigs against live S. dysenteriae. In the current study, we compared the intranasal and intraperitoneal routes of immunizations with the DM104 vaccine strain in mice to understand the better route of administration of the DM104 vaccine and its immunogenicity as well as protective efficacy in mouse model. The results indicate that the immune response elicited by the DM104 strain is strongly dependent on the immunization route, with the intranasal route being more effective than the intraperitoneal route following intraperitoneal live S. dysenteriae challenge. Intranasal immunization yielded 80% protective efficacy in immunized mice whereas, intraperitoneal immunization could not provide any protection. Protection generated by intranasal immunization was accompanied by high titre of anti-whole cell lysate IgG and IgA in DM104 immunized sera compared to sera collected from mice of control group. All these data demonstrate the intranasal route of the vaccine DM104 strain in mouse model to be a better immunization route to protect the animals against live S. dysenteriae challenge. Bangladesh J Microbiol, Volume 37 Number 2 December 2020, pp 38-41

Background: Antibiotic resistance due to misuses of antibiotics is currently became potent threat for treating patients suffering from infectious diseases in Bangladesh. It is the high time to develop some alternative placebo for the treatment of infectious diseases especially in Bangladesh. Probiotic especially E. coli could be that alternative choice of treatment against Shigella infection. Aims: The present study was undertaken to examine the potentiality of Escherichia coli as probiotic against Shigella. Materials and Methods: During this study, four poor hygienic areas around Chattogram City, Bangladesh were selected through survey and then human stool samples were collected. Isolation and identification of Escherichia coli were done with a combination of microbiological and PCR analysis. Probiotic activity of isolated E. coli against Shigella was determined by co-culture test. Results: Total eight isolates were identified as Escherichia coli by microbiological and biochemical test. All the isolates were also confirmed as bacteria, coliform as well as fecal coliform through PCR. In the probiotic activity test, all the identified isolates except one showed significant result as probiotic. Conclusion: This research identified the potentiality of Escherichia coli as probiotic to treat shigellosis in Bangladesh. The outcomes of this study might function as a strong background to develop Escherichia coli as probiotic against Shigella infection in Bangladesh. Keywords: Antibiotic resistance, Probiotic, Escherichia coli, Shigella, PCR.

The relevance of the study of Shigellosis is due to the fact that the pathogen is capable of invasion and the production of cyto- and neurotoxins, which leads to the development of severe inflammation and toxicosis, and with massive infection — and neurotoxicosis. Purpose: to study the clinical and laboratory features of the course of Shigellosis in hospitalized patients at the present stage. Materials and Methods: a retrospective study of 17 case histories of children aged 9 month to 17 years old, hospitalized in the infectious diseases department of a Moscow hospital in 2019 with a confirmed diagnosis of Shigellosis, was carried out. Results: depending on the season, the frequency of hospitalizations of children with Shigellosis was practically the same in autumn, winter and spring, excluding summer (35%, 35%, 30% and 0%, respectively). Children with Shigellosis under the age of 1 year were 2, 1—3 years old — 4, 3—7 years old — 5, 7—14 years old — 3, over 14 years old — 3. The diagnosis of Shigellosis was confirmed in 13 patients according to the results of bacteriological research , in 4 — according to IHR (indirect hemagglutination reaction) data (without seeding). Shigella flexneri 2a was detected in 14 children, Shigella sonnei in 2, Shigella flexneri 2a together with Shigella sonnei in 1. Most of the patients 82.4% (14/17) were admitted to the hospital in the first three days of illness (by 2.8 ± 0.05 days). Intoxication symptoms were expressed in all patients, vomiting — in 76.5% of cases (13/17), fever — in 94% (16/17), abdominal pain — in 82.4% (14/17), inflammatory impurities in feces (cloudy mucus) — in all patients, hemocolitis (streaks of blood in feces) — in all but one — 94% (16/17). In one third of patients, Shigellosis was severe — in 35% (6/17). Conclusions. Shigellosis remains relevant due to the incidence of hemocolitis, severe forms, which requires hospitalization.

Background: Although shigellosis is self-limiting, antibiotics are recommended to minimize the severity of symptoms and reduce mortality rates. However, due to the increasing reports of antibiotic resistance, alternative approaches are needed to combat shigellosis. Interest for research on medicinal plants has increased in recent years, and hence, they can be explored to treat this infectious diarrhoea. Objective: To study the effect of Psidium guajava L. (guava) leaf decoction (GLD) on the antibiotic-resistant clinical isolates of Shigella spp. Materials and Methods: A total of 43 isolated Shigella spp. from diarrhoeal patients were used in this study. The effect of GLD on the bacterial viability was initially assessed. The isolates were divided into two categories: sensitive and resistant to GLD. For sensitive isolates, antibacterial activity of GLD was evaluated while for resistant strains, the ability of GLD for reducing the bacterial invasion of the HEp-2 cell line underwent an investigation. Results: Among the 43 Shigella isolates, GLD affected the growth of 23 strains. The invasion of 9 strains from the 20 remaining resistant isolates was unaffected. Although the number of isolates was less, the data suggested that isolates belonging to S. flexneri serogroup were more sensitive to GLD in comparison with other spp (i.e., sonnei, boydii, and dysenteriae). Conclusion: The results of this study revealed the efficacy of GLD against drug-resistant Shigella spp. and thus could be considered for the treatment of diarrhoea. GLD can be a cost-effective alternative to antibiotics.

Shigella spp. are water-borne pathogens responsible for mild to severe cases bacilli dysentery all around the world known as Shigellosis. The progressively increasing of antibiotic resistance among Shigella calls for developing and establishing novel alternative therapeutic methods. The present study aimed to evaluate a novel phage cocktail of lytic phages against extended spectrum beta lactamase isolates of Shigella species in an aquatic environment. The phage cocktail containing six novel Shigella specific phages showed a broad host spectrum. The cocktail was very stable in aquatic environment. The cocktail resulted in about 99% decrease in the bacterial counts in the contaminated water by several species and strains of Shigella such as Shigella sonnei, Shigella flexneri and Shigella dysenteriae. Achieving such a high efficiency in this in-vitro study demonstrates a high potential for in-vivo and in-situ application of this phage cocktail as a bio-controlling agent against Shigella spp. contamination and infections.

Introduction Shigellosis cases have decreased gradually in Japan in recent years, but indigenous shigellosis outbreaks sometimes occur in childcare facilities. From national surveillance data, we identified a shigellosis outbreak involving a kindergarten. Methods After detecting Shigella sonnei in Kitakyushu City, we conducted active case finding and epidemiological investigation in Kindergarten Z, including stool specimen collection and interviews. The stool specimens were cultured, and isolated strains were subjected to pulsed-field gel electrophoresis (PFGE) and multiple-locus variable-number tandem-repeat analysis (MLVA). Results Between September 1 and December 31, 2014, we identified 19 cases: 14 confirmed, 2 suspected, and 3 asymptomatic. Of the 19 cases, 16 were epidemiologically associated with Kindergarten Z (10 pupils, 5 family members, and 1 teacher). On October 19, a pupil with gastrointestinal illness participated in the kindergarten's sports festival, in which the pupils were split into “red” and “white” teams; the pupil in question belonged to the red team. Attack rates of the red and white teams were 8% (7/82) and 0% (0/108), respectively (relative risk, 10.5; 95% confidence interval, 1.3–82.1). PFGE patterns were identical or similar for the isolates in all 17 cases; 7 isolates were identical, and the others had one locus difference on MLVA. Conclusions We concluded that contact during the sports festival could have been responsible for spread of the shigellosis outbreak at the kindergarten, although the infection source was not determined. It is vital to inform guardians immediately after detection of shigellosis cases that symptomatic pupils should not participate in activities such as sports festivals.

Shigellosis, acute inflammatory bacillary dysentery diseases, is an important agent in the mortality of children in developing countries. Annually 165 million people are being infected leading to 1.2 million deaths around the world. Although vaccination appears to be the only rational prophylactic approach to control shigellosis, currently, there is no safe and efficacious vaccine available in the market. Here in this study, we investigated the protection conferred by a new vaccine based on nanoparticles containing outer membrane vesicles (OMVs) of Shigella sonnei in an experimental model of shigellosis in mice. OMVs extracted by deoxycholate detergent were encapsulated in chitosan-TPP nanoparticles prepared by an ion gelation method and coated with an enteric polymer (NP-OMVs). NP-OMVs were spherical and homogeneous with a mean size of 344.7 nm (PdI = 0.2). BALB/c mice (females, 9-week-old, 25 ± 1 g) were immunized intraperitoneally (i.p.) with 20 µg of OMVs or by intragastric route (i.g.) with 50 µg of free or encapsulated OMVs. The protein concentrations of OMVs were 0.65 mg/mL and 1.02 mg/mL for bacteria grown at 37 C and 42 C respectively. OMVs loaded into nanoparticles were homogeneous and spherical, with a size of 344 nm. The encapsulation efficiency of NP was 85%. Antibody titers in immunized mice sera after 78 days revealed a persistent immune response. Free OMVs were able to protect against infection when it was administered by the intraperitoneal route. Oral administration of NP-OMVs showed better protection whereas free OMVs did not protect against infection. The results obtained in this research place OMVs among promising candidates to be used for vaccination.

Background Shigella is a leading cause of childhood diarrhea and target for vaccine development. Microbiologic and clinical case definitions are needed for pediatric field vaccine efficacy trials. Methods We compared characteristics of moderate to severe diarrhea (MSD) cases in the Global Enteric Multicenter Study (GEMS) between children with culture positive Shigella to those with culture-negative, quantitative polymerase chain reaction (qPCR)-attributable Shigella (defined by an ipaH gene cycle threshold, Molecular methods identified Shigella more commonly than microbiologic culture in younger and stunted children. A simplified clinical score containing dehydration, hospitalization, and diarrhea duration could be used to stratify vaccine trial endpoints by severity based on its ability to predict death.

Background :Diarrhea is one of the causes of morbidity and mortality in infants and children around the world. One of the causes of diarrhea is Shigella sp bacteria or shigellosis. Nowadays, many antibiotics resistant to the Shigella sp bacteria are one example of chloramphenicol, so it is necessary to have other alternatives such as natural ingredients. Objective: Determine the activity of the red onion (Allium cepa L) and garlic (Allium sativum), which is known to possess antibacterial phytochemical compounds against the Shigella dysenteriae bacteria. Method: This research is a laboratory experimental study to determine antibacterial activity using the Kirby-Bauer or diffusion method of discs and to determine the presence of Minimum Inhibitory Concentration (MIC) and Minimum Bacterial Concentration (MBC). The study uses five treatments i.e., onion extracts and garlic extracts with a concentration of 30%, 40%, 50%, 60%, 70%, control positive (Ciprofloxacin), and negative control (aquadest). Results: Red onion diffusion has the best antibacterial activity at concentrations 70% while garlic has the best antibacterial activity at a concentration of 70%. In this study, there were no MIC and MBC. The MIC data analyzed with the crucial test of Kruskal-Wallis (p < 0.05) i.e., in onion extract p = 0.003 and in garlic P = 0.003, which means significant. The MBC Data is analyzed by crucial test (P < 0.05) in the onion extract p = 0.003 and on garlic p = 0.04. Conclusion : the disc diffusion and the MBC can be concluded that garlic extract can inhibit the growth of S. dysenteriae compared to red onion extracts. onion extracts).

Shigella sonnei is the emerging pathogen globally, as it is the second common infectious species of shigellosis (bloody diarrhoea) in low- and middle-income countries (LMICs) and the leading one in developed world. The multifactorial processes and novel mechanisms have been identified in S. sonnei, that are collectively playing apart a substantial role in increasing its prevalence, while replacing the S. flexneri and other Gram-negative gut pathogens niche occupancy. Recently, studies suggest that due to improvement in sanitation S. sonnei has reduced cross-immunization from Plesiomonas shigelliodes (having same O-antigen as S. sonnei) and also found to outcompete the two major species of Enterobacteriaceae family (Shigella flexneri and Escherichia coli), due to encoding of type VI secretion system (T6SS). This review aimed to highlight S. sonnei as an emerging pathogen in the light of recent research with pondering aspects on its epidemiology, transmission, and pathogenic mechanisms. Additionally, this paper aimed to review S. sonnei disease pattern and related complications, symptoms, and laboratory diagnostic techniques. Furthermore, the available treatment reigns and antibiotic-resistance patterns of S. sonnei are also discussed, as the ciprofloxacin and fluoroquinolone-resistant S. sonnei has already intensified the global spread and burden of antimicrobial resistance. In last, prevention and controlling strategies are briefed to limit and tackle S. sonnei and possible future areas are also explored that needed more research to unravel the hidden mysteries surrounding S. sonnei.

In a cohort of infants, we found that lack of the Lewis histo-blood group antigen was associated with increased susceptibility to shigellosis. Broadly inhibiting fucosylation in epithelial cells in vitro decreased invasion by Shigella flexneri. These results support a role for fucosylated glycans in susceptibility to shigellosis.

To study the clinical characteristics and factors associated with mortality among children with Shigella encephalopathy. The data collection was done prospectively from January, 2018 to May, 2019 with retrospective data from June, 2016 to December, 2017. The study cohort consisted of 58 children 12 hours) were found to be independently associated with mortality. Recognition of factors associated with mortality in Shigella encephalopathy may assist in better monitoring of sicker children and improved outcomes.

Background: Although the short-term neurological complications of Shigella spp. are well described, potential neuropsychiatric outcomes have not been studied yet. We investigated the association between early childhood shigellosis and subsequent ADHD. Methods: This is a retrospective population-based cohort. Using a large Health Maintenance Organization database, the prevalence of ADHD was investigated among children aged 5–18 years who underwent stool culture prior to the age of 3 years. Results: Of 52,761 children with a stool culture examined, 5,269 (9.98%) had Shigella-positive results. The rate of ADHD was 10.6% and 8.6% among children with Shigella-positive and Shigella-negative stool cultures, respectively ( p < .001). Adjusted odds ratio for ADHD after controlling for gender and socioeconomic status was 1.21 (CI 1.13–1.29, p < .001). The younger the child was during Shigella gastroenteritis, the higher was the association with ADHD ( p < .001). Conclusion: Early childhood shigellosis is associated with an increased rate of long-term ADHD.

Проведено аналіз клініко-параклінічних особливостей шигельозу у 72 дітей, хворих на шигельоз середньої тяжкості, в залежності від наявності або відсутності інфікування цих дітей цитомегаловірусом (ЦМВ). Встановлено, що шигельоз у дітей, інфікованих ЦМВ, перебігає переважно у формі ентероколіту, супроводжується більш високими цифрами температурної реакції тіла в дебюті хвороби, гіперемією задньої стінки ротоглотки, лімфоаденопатією, гепатомегалією, ознаками паренхіматозної реакції печінки. У цих дітей реєструють триваліші строки регресії клінічних симптомів – пролонгацію збереження лихоманки і порушення загального стану, диспепсичні явища, абдомінальний синдром, триваліше збереження ознак гепатомегалії, що призводить до збільшення строків перебування хворих у стаціонарі та є одним із факторів розвитку нозокоміальної інфекції.

The globally increasing incidence of antibiotic resistance in pathogenic microorganisms such as Shigella, a cause of human acute gastrointestinal infections, calls for developing effective alternatives. In this study, the antibiotic resistance pattern, extended-spectrum β-lactamase (ESBL)-production, and molecular characteristics of 70 multidrug-resistant isolates belong to the two most frequent species of Shigella genus, that is, Shigella sonnei (44 isolates) and Shigella flexneri (26 isolates) were investigated. These isolates were used to evaluate both specificity and activity of Shigella-specific bacteriophages, vB_SflS-ISF001, vB_SsoS-ISF002, and a cocktail of both. Twelve out of the 21 tested resistance genes were detected in the isolates. About 59% of S. sonnei and 46% of S. flexneri isolates were identified as ESBL producers. The bacteriophages showed a high efficiency of plating (EOP ≥0.5) in about 75% of the isolates. Moreover, the growth of >85% of the isolates was inhibited by the phage cocktail of vB_SflS-ISF001 and vB_SsoS-ISF002. The phage cocktail was effective against a wide range of ESBL-positive and -negative isolates of S. sonnei and S. flexneri. Therefore, this phage cocktail has the potential to inhibit or significantly decrease the spread of drug-resistant Shigella in humans, food chains, and water/wastewater sanitation systems.

A qualitative study among gay and bisexual men examining shigellosis-related knowledge, attitudes, and practices revealed low knowledge levels, limited concern about shigellosis, and mixed intention to engage in prevention behaviors., Background Shigellosis is a highly contagious enteric bacterial disease transmitted through the fecal-oral route. It is primarily transmitted through person-to-person contact and via contaminated food and water. Outbreaks of shigellosis among men who have sex with men (MSM) attributed to sexual person-to-person contact have been reported. These outbreaks are of concern because they are often caused by multidrug-resistant strains of Shigella. Little is known about shigellosis-related knowledge, attitudes, and practices among gay, bisexual, and other MSM. Methods Six focus groups were conducted among self-identified gay or bisexual men in Atlanta, GA, in Fall 2017. Participants were asked about shigellosis-related knowledge, attitudes, and practices. Focus groups were audio recorded, and the transcribed audio was analyzed using inductive and deductive thematic coding. Results Among the 24 focus group participants, most perceived that diarrheal illness was caused by contaminated food. Knowledge of shigellosis and Shigella was low, with most never having heard of the disease or bacteria. Participants did not perceive shigellosis to be a serious health concern, especially when compared with HIV; however, they did perceive gay and bisexual men to be at risk of Shigella infection. Participants reported mixed intentions to change sexual behaviors to prevent shigellosis or talk with sexual partners about diarrhea. Conclusions Health communication and education efforts could be used to increase knowledge about shigellosis and shift perceptions about the severity of shigellosis among gay, bisexual, and other MSM. Additional work is needed to identify effective ways to promote shigellosis-related prevention behaviors among gay, bisexual, and other MSM.

Background Sex differences in the incidence of infectious diseases can provide insight to the biological mechanism of infection, disease susceptibility, severity and vaccine development. The consistency of age-specific sex differences in the incidence rates (IRs) of shigellosis is unclear. Methods National data on cases of shigellosis by sex, age group and calendar year were obtained from nine countries, for a period of 6–25 years. The male to female incidence rate ratios (RR) were calculated by country, years and age group. For each age group, meta-analytic methods were used for computing pooled incidence RRs by country and years. Meta-regression was performed to estimate the contribution of age, country and time period to the differences in the male : female RRs. Results In the age groups Conclusions The higher IRs in male infants and young children does not appear to be related to behavioral factors and genetic and hormonal factors could be important. In the older age groups, the higher rates in adult females may be due to behavioral factors.

Acute intestinal infections, including intestinal amebiasis, remain a pressing public health problem. Amebiasis still represents an important and partially solved problem to health care. In the Astrakhan region, intestinal amebiasis is being continuously recorded. We analyzed the clinical picture of acute intestinal amebiasis in 150 adult patients dominated by female patients comprising 60.7%, aged 18 to 79 years old, and treated within 2010–2016 at the Regional Infectious Clinical Hospital. All patients were mostly of young and middle age (up to 50 years) — 108 patients. More than 50% of patients were admitted to the hospital within the first three days of the disease. However, in 35 cases (23.3%), late hospitalization was carried out (5 days after the onset). Proper diagnosis was made to 44 patients (29.3%), most commonly diagnosing preliminarily with acute gastroenteritis and acute dysentery. All cases of intestinal amebiasis were confirmed by detecting in the feces of patients with a vegetative form of entamoeba histolytica. The disease was featured with sporadic course, being mostly recorded during the summer-autumn period (78.0%). In 142 patients (94.7%), the moderate severity was observed. Cardiovascular disorders were mainly found in severe amebiasis as well as patients comorbid with cardiovascular diseases. A coprological method was used to confirm the diagnosis. Microscopic examination of feces was carried out immediately after defecation (warm type). A combination therapy was applied to patients with intestinal amebiasis. A great attention was paid to patient nutrition: high-protein sparing diet, grated food. Patients with ulcerative colitis received individualized diet (restricted carbohydrates, exclusion of milk and fiber). Etiotropic therapy was carried out with using 5-nitroimidazole preparations: metronidazole (Trichopol, Flagin, Tiberal), MacGioror, Tinidazole (Phasycin) combined with tetracycline. The treatment included group B vitamin cocktail, methyluracil (suppository), enzymes (creon, mezim, pancreatin), enterosorbents (smecta, polyphepan, enterosgel), antispasmodics (no-spa, drotaverin). Patients were administered with therapeutic microenemas containing furacilin solution, rosehip oil, and sea buckthorn oil. Infusion therapy consisting of polyionic solutions was applied by assessing blood electrolyte level. Fresh frozen plasma and albumin were transfused upon decline of serum protein and albumin level. Packed erythrocytes Erythrocyte mass and hemostatic drugs were injected in case of severe intestinal amebiasis if indicated: dicynone, cryoprecipitate, and calcium preparations. Finally, anemia cases were treated as well. In all cases, the disease outcome was favorable, without any mortality. Complications were noted in the form of intestinal bleeding observed in 6 patients (4.0%), wherein amebiasis proceeded together with ulcerative colitis. Acute intestinal amebiasis is currently featured with typical clinical picture that proceeds with less severe symptoms. Intestinal bleeding was observed in patients with intestinal amoebiasis in combination with ulcerative colitis. Chronization of intestinal amebiasis occurs in single cases (3.9%).

Objectives. To investigate a shigellosis outbreak in Genesee County, Michigan (including the City of Flint), and Saginaw County, Michigan, in 2016 and address community concerns about the role of the Flint water system. Methods. We met frequently with community members to understand concerns and develop the investigation. We surveyed households affected by the outbreak, analyzed Shigella isolate data, examined the geospatial distribution of cases, and reviewed available water quality data. Results. We surveyed 83 households containing 158 cases; median age was 10 years. Index case-patients from 55 of 83 households (66%) reported contact with a person outside their household who wore diapers or who had diarrhea in the week before becoming ill; results were similar regardless of household drinking water source. Genomic diversity was not consistent with a point source. In Flint, no space-time clustering was identified, and average free chlorine residual values remained above recommended levels throughout the outbreak period. Conclusions. The outbreak was most likely caused by person-to-person contact and not by the Flint water system. Consistent community engagement was essential to the design and implementation of the investigation.

Shigellosis is a diarrheal disease that causes high mortality every year, especially in children, elderly and immunocompromised patients. Recently, resistance strains to antibiotic therapy are in the rise and the World Health Organization prioritizes the development of a safe vaccine against the most common causal agent of shigellosis, Shigella flexneri. This pathogen uses autotransporter proteins such as SigA, Pic and Sap to increase virulence and some of them have been described as highly immunogenic proteins. In this study, we used immune-informatics analysis to identify the most antigenic epitope as a vaccine candidate on three passenger domains of auto-transporter proteins encoded on the pathogenic island SHI-1, to induce immunity against S. flexneri. Epitope identification was done using various servers such as Bepipred, Bcepred, nHLAPRED, NetMHCII, Rankpep and IEDB and the final selection was done based on its antigenicity using the VaxiJen server. Moreover, to enhance immunity, the GroEL adjuvant was added to the final construct as a Toll-like receptor 2 (TLR2) agonist. On the other hand, to predict the tertiary structure, the I-TASSER server was used, and the best model was structurally validated using the ProSA-web software and the Ramachandran plot. Subsequently, the model was refined and used for docking and molecular dynamics analyses with TLR2, which demonstrated an appropriate and stable interaction. In summary, a potential subunit vaccine candidate, that contains B and T cell epitopes with proper physicochemical properties was designed. This multiepitope vaccine is expected to elicit robust humoral and cellular immune responses and vest protective immunity against S. flexneri.

Background Azithromycin is frequently used to treat shigellosis; however, clinical outcomes are uncertain. Methods We performed an observational cohort study in Bangladesh of patients with invasive diarrhea treated empirically with azithromycin. Susceptibility testing was performed by broth microdilution and disk diffusion post hoc on all Shigella isolates and clinical response was correlated with in vitro susceptibility. Results There were 149 Shigella culture-positive patients in the primary analysis. Infection with Shigella with decreased susceptibility to azithromycin was significantly associated with persistence of diarrhea at day 5 (31% vs 12%; relative risk [RR], 2.66; 95% confidence interval [CI], 1.34–5.28), culture positivity at day 5 or 6 (35% vs 5%; RR, 5.26; 95% CI, 1.84–14.85), and a higher rate of overnight hospitalization (58% vs 39%; RR, 1.49; 95% CI, 1.06–2.09). Shigella flexneri was more common than Shigella sonnei (58% vs 36%); however, S. sonnei constituted most of the isolates with decreased susceptibility to azithromycin (67%) and most of the multidrug-resistant strains (54%); thus, poor clinical outcomes were associated with S. sonnei. The current epidemiological cutoff for S. flexneri of ≥16 µg/mL to define decreased susceptibility to azithromycin was clinically predictive of poor outcome. Patients with S. sonnei and a low MIC (4 µg/mL) still had elevated rates of persistent diarrhea and culture positivity. Conclusions This study documents worse clinical outcomes for S. flexneri with decreased susceptibility to azithromycin, as well as S. sonnei, and supports the utility of susceptibility testing and clinical breakpoints for azithromycin. S. sonnei is an emerging drug-resistant threat. Clinical Trials Registration NCT03778125.

Shigellosis outbreaks caused by Shigella with decreased susceptibility to azithromycin (DSA-Shigella) among men who have sex with men (MSM) have been reported worldwide. We describe sexual health indicators and antimicrobial drug resistance for shigellosis cases in Minnesota, USA. We analyzed a sample of isolates received during 2012-2015 and cross-referenced cases with the Minnesota Department of Health Sexually Transmitted Disease Database to ascertain patients' HIV status and recent chlamydia, gonorrhea, and syphilis infections. Of 691 Shigella isolates, 46 (7%) were DSA-Shigella; 91% of DSA-Shigella patients were men, of whom 60% were living with HIV. Among men, those with DSA-Shigella infection had greater odds of living with HIV, identifying as MSM, or having a recent diagnosis of a sexually transmitted disease. DSA-Shigella was associated with MSM, HIV infection, and recent sexually transmitted disease. To decrease spread of DSA-Shigella, interventions targeted at communities at high risk are needed.

BackgroundDeveloping countries exhibit a high disease burden from shigellosis. Owing to the different incidences in males and females, this study aims to analyze the features involved in the transmission of shigellosis among male (subscriptm) and female (subscriptf) individuals using a newly developed sex-based model.MethodsThe data of reported shigellosis cases were collected from the China Information System for Disease Control and Prevention in Hubei Province from 2005 to 2017. A sex-based Susceptible–Exposed–Infectious/Asymptomatic–Recovered (SEIAR) model was applied to explore the dataset, and a sex-age-based SEIAR model was applied in 2010 to explore the sex- and age-specific transmissions.ResultsFrom 2005 to 2017, 130 770 shigellosis cases (including 73 981 male and 56 789 female cases) were reported in Hubei Province. The SEIAR model exhibited a significant fitting effect with the shigellosis data (P 8forSARmm(secondary attack rate from male to male), 2.5729 × 108forSARmf, 2.7630 × 10-8forSARfm, and 2.1061 × 10-8forSARff. The top five mean values of the transmission relative rate in 2010 (where the subscript 1 was defined as male and age ≤ 5 years, 2 was male and age 6 to 59 years, 3 was male and age ≥ 60 years, 4 was female and age ≤ 5 years, 5 was female and age 6 to 59 years, and 6 was male and age ≥ 60 years) were 5.76 × 10-8forβ61, 5.32 × 10-8forβ31, 4.01 × 10-8forβ34, 7.52 × 10-9forβ62, and 6.04 × 10-9forβ64.ConclusionsThe transmissibility of shigellosis differed among male and female individuals. The transmissibility between the genders was higher than that within the genders, particularly female-to-male transmission. The most important route in children (age ≤ 5 years) was transmission from the elderly (age ≥ 60 years). Therefore, the greatest interventions should be applied in females and the elderly.

The analysis of the cellular immune response indicators in shigellosis in 90 children aged four to ten years infected with cytomegolovirus. It was found that in the acute period of the disease in children with mixed infection, the content of CD3 +, CD4 + and CD8 + cells of peripheral blood decreases, and by the period of early reconvalescence, the full recovery of cellular immunity indicators in these children does not occur. The revealed features of cellular immunity in shigellosis in children infected with CMV may be the cause of an unfavorable course of the disease and require further research.

Shigellosis is an enteric disease with high morbidity and mortality, particularly in developing countries. There is currently no licensed vaccine available. Most infection is caused by Shigella flexneri, of which 30 serotypes have been recognized based on O-antigen polysaccharide structure. Almost all S. flexneri serotypes share the same repeating unit backbone (serotype Y), with varying glucosylation, O-acetylation and phosphorylation. The O-antigen is the primary vaccine target; the vaccine valency (and hence cost) can be reduced by cross-protection. Our planned systematic conformational study of S. flexneri starts here with 2a, the dominant cause of infection globally. We employ microsecond molecular dynamics simulations to compare the conformation of the unsubstituted serotype Y backbone with the serogroup 2 O-antigens, to investigate the effect of glucosylation and O-acetylation (O-factor 9) on conformation. We find that serotype Y is highly flexible, whereas glucosylation in 2a restricts flexibility and induces C-curve conformations. Further, the glucose side-chains adopt two distinct conformations, corroborated by the antibody-bound crystal structure data. Additional substitution on O-3 of rhamnose A (whether O-acetylation in 2a or glucosylation in 2b) induces helical conformations. Our results suggest that the O-3-acetylated 2a antigen will elicit cross-protection against 2b, as well as other serotypes containing O-factor 9.